Multistate plans may roll out with a thud - AARP eyeing Hispanic outreach - Closeup on Louisville as the health law is ready for implementation - Massachusetts voters to name Kerry successor

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MULTISTATE PLANS MAY ROLL OUT WITH A THUD — Multistate insurance plans, the consolation prize for Obamacare supporters who had pushed for a public option, may have little impact on the competition available to consumers in exchanges this fall. Pro’s Brett Norman reports only Blue Cross Blue Shield intends to offer plans in all 50 states, but they’re not much different than the plans already offered by the company: “At least five states have publicly said that multistate plans will be offered on their exchanges next year — Arkansas, Kansas, Maryland, Michigan and Montana. All except Maryland have identified Blue Cross affiliates as the sponsors. … And some insurance regulators believe that HHS wrote the multistate plan regulations so that the Blue Cross Blue Shield Association, a nonprofit umbrella group of Blue Cross affiliates, could be counted as the nonprofit contractor.” http://politico.pro/19h4SYx

Happy Monday and welcome to PULSE, where we like to think daredevil Nik Wallenda’s tightrope walk across the Grand Canyon last night is akin to what HHS will be going through between now and the Oct. 1 implementation of Obamacare: risky, precise and closely scrutinized by gawkers equally interested in success or grisly failure. http://lat.ms/11XPDvd

“Whatever tomorrow brings, PULSE’ll be there.”

AARP EYEING HISPANIC OUTREACH — AARP announced an effort this morning to ramp up the Obamacare sales pitch in Hispanic communities to help a population with a disproportionately high rate of uninsurance. In conjunction with groups like the Hispanic Federation, National Council of La Raza, Esperanza and the League of United Latin American Citizens, AARP plans to help train people to promote the law within their communities.

MARK YOUR CALENDARS — POLITICO has announced the first in a new series of POLITICO Pro Twitter Chats. Your PULSErs, @KyleDCheney and @JasonMillman will take to Twitter tomorrow at 1:30 p.m. ET to talk all things Obamacare as the one-year anniversary of its SCOTUS ruling approaches. Come armed with questions on the soon-to-go-live exchanges or states still grappling with Medicaid expansion. Join the conversation on POLITICO.com/ProChat or on Twitter, using hashtag #ProChat.

CLOSEUP ON LOUISVILLE AS THE HEALTH LAW IS READY FOR IMPLEMENTATION — The New York Times plans to spotlight Louisville as the Affordable Care Act takes effect around the country, citing the city’s position as a bellwether for the country — a place where the law packs huge potential but anxiety is running high: “For doctors and their staffs, this is a period of fevered preparation for the far-reaching changes that are soon to come as the law moves out of the realm of political jousting and into the real world,” the Times’s Abby Goodnough reports. http://nyti.ms/14harzt

MASSACHUSETTS VOTERS TO NAME KERRY SUCCESSOR — Democratic Rep. Edward Markey has maintained a consistent lead over rival Republican Gabriel Gomez, although it’s not a complete runaway. In the final days of the race, armchair analysts have suggested Gomez failed where Scott Brown succeeded in winning over female voters. POLITICO’s James Hohmann reports: “At the first debate, [Gomez] suggested both that he could vote to confirm a Supreme Court justice who would roll back Roe v. Wade and that he would support a 24-hour waiting period before a woman could have an abortion. … Democrats identify a turning point in the race as when Gomez declined to take a position on the Blunt Amendment — which would have allowed employers to restrict coverage for contraception — saying he had not read the text.” http://politi.co/173wNqE

** CVS Caremark is a pharmacy innovation company. We are a retail pharmacy focused on controlling costs, a pharmacy benefit manager making complex specialty care less complex and a retail medical clinic providing convenient access to care. Every day, we’re working to make health care better. **

OTHER STORYLINES TO WATCH THIS WEEK:

— HAPPY ANNIVERSARY, SCOTUS RULING — Friday marks a year to the day the Supreme Court upheld Obamacare but left Medicaid expansion decisions to the states, a ruling that kicked off a wave of partisan political battles in state capitals across the country. Looking back, it’s clear that a lot of the pundits who predicted the court ruling would spell the end of political upheaval over the law were, perhaps, a tad misguided.

— SPEAKING OF SCOTUS … — The court is expected to rule either today or Thursday on the constitutionality of the Defense of Marriage Act, and the decision carries major health care ramifications for same-sex couples. DOMA excludes same-sex couples from protections offered to heterosexual couples under federal health programs including Medicare, Medicaid and COBRA.

— MISSISSIPPI COUNTDOWN — If lawmakers are going to step in and save the state’s Medicaid program from expiring, this is the week to do it. The program for 700,000 residents is set to expire on July 1 unless Mississippi Gov. Phil Bryant calls the Legislature back into a special session to reauthorize it. Although both parties want to do that, Democrats insist there must first be a debate and vote on Medicaid expansion, one Republicans thus far have been unwilling to entertain. Speaker Philip Gunn hasn’t returned requests for comment on why he’s not willing to call a vote, but the stalemate could come to a head this week.

—T-MINUS 99 DAYS TO ACA LAUNCH — It all comes down to the next 99 days, a sprint to Oct. 1, when state and federal exchanges will go live and plans will begin enrolling people in coverage. It also marks the beginning of an all-out effort by supporters of the law to push for the greatest possible awareness of what the law has to offer and persuade young, uninsured Americans to sign up.

STATE WEEK — It’s the home stretch for most legislatures that haven’t already wrapped up their work for the year. The July 1 start of the new fiscal year in the majority of states means final spending blueprints for the coming year will be landing on governors’ desks across the country. In them will likely be solutions to Medicaid expansion that have been elusive. Last week, lawmakers in Maine and Michigan failed to reach agreement, Mississippi barreled toward a high-stakes showdown and Pennsylvania supporters tried to revive an expansion plan.

IN ARIZONA, MEDICAID EXPANSION OPPONENTS LOOKING FOR HELP — Conservative critics of the health law in Arizona say they’re looking for 120,000 voter signatures to halt the expansion for at least a year, when voters will have a chance to decide whether to wipe it from the books. They actually need about 85,000 signatures, but opponents — under the banner “United Republican Alliance of Principled Conservatives” — are eyeing a cushion to make sure they have enough room in case of challenges.

WHAT WE’RE READING

Jonathan Blum, deputy administrator of CMS, argues that competitive bidding for medical equipment in Medicare has saved hundreds of millions of dollars: http://politi.co/10et1sF

The New York Times’s Reed Abelson looks at employers who are beginning to experiment with plans that pay consumers a fixed amount for the cost of certain services, requiring them to pay the rest: http://nyti.ms/173xT60

USA Today opines that the proposed immigration reform legislation is as strict as it should be on health benefits: http://usat.ly/12kcH6f

The Philadelphia Inquirer editorial board makes a late push for state lawmakers to approve Medicaid expansion: http://bit.ly/10eMae6

** CVS Caremark is more than a pharmacy. We are a pharmacy innovation company that combines a retail pharmacy, a pharmacy benefit manager and a retail medical clinic. We create better health care solutions and seek to control costs in Medicaid and Medicare Part D. We make complex specialty care less complex. We are 7,500 retail stores staffed by highly trained pharmacists who improve coordination of care to ensure that patients stay on their prescribed medications. We are one of the largest pharmacy benefit managers in the country, finding new ways to make prescription medications more affordable. We are a retail medical clinic with over 650 locations, providing convenient access to care. Every day, we’re working to make health care better. **

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